Congenital Heart Surgery is a surgical procedure performed to correct structural abnormalities resulting from the defective development of the baby's heart or major blood vessels in the womb.
✓What is Congenital Heart Disease Surgery?
Congenital Heart Disease surgery is a medical specialty that involves the surgical treatment of congenital heart and major vessel anomalies. These diseases result from defects that develop in the structure of the heart or blood vessels before birth. While some Congenital Heart Disease conditions may be incompatible with life, others may produce no symptoms and may be discovered incidentally years later. Congenital Heart Disease surgery aims to restore the normal anatomical and functional structure of the heart, particularly through surgeries performed during infancy and childhood.
✓Congenital Heart Disease - Acyanotic Heart Disease
In acyanotic heart disease, oxygen levels in the bloodstream are usually normal. In these types of diseases, there is abnormal blood flow from the left heart to the right heart.
✓Atrial Septal Defect (ASD): A condition where there is a hole between the heart's atria.
✓Ventricular Septal Defect (VSD): A hole in the wall between the heart's ventricles.
✓Patent Ductus Arteriosus (PDA): A vessel (ductus arteriosus) that should close after birth remains open.
✓Pulmonary Stenosis: Narrowing in the blood vessel going to the lungs.
✓Aortic Coarctation: Narrowing exists in a specific section of the aorta.
✓Congenital Heart Disease - Cyanotic Heart Disease
Tetralogy of Fallot: A complex disease in which four separate heart anomalies are present together.
✓Transposition: A congenital anomaly where the main arteries (aorta and pulmonary artery) are switched.
✓Truncus Arteriosus: A single large blood vessel exists coming from the heart.
✓Total Anomalous Pulmonary Venous Return (TAPVD): Oxygenated blood returning from the lungs returns to the heart incorrectly.
✓Tricuspid Atresia: Absence of passage between the right atrium and right ventricle.
✓Causes of Congenital Heart Disease
Congenital heart disease results from a developmental problem that occurs early in the heart's structure. The defect typically interferes with normal blood flow through the heart, which can affect breathing. Although researchers are not entirely certain why the heart does not develop properly, suspected causes include:
✓Heart defects are more likely to be seen in families with a history of heart defects.
✓Taking certain medications during pregnancy puts a child at higher risk for heart defects.
✓Using alcohol or illegal drugs during pregnancy can increase a child's risk of having a heart defect.
✓Mothers who had viral infections in the first three months of pregnancy are more likely to have a child with a heart defect.
✓Increased blood sugar levels, as in diabetes, can affect childhood development.
✓Women who have had a child with a congenital heart defect have a higher risk of having another child with a heart defect.
✓Heart defects can occur together with other birth defects.
✓What are the Symptoms of Congenital Heart Disease?
Congenital heart defects are typically detected during pregnancy ultrasound. For example, if your doctor hears an abnormal heartbeat, they may perform certain tests to investigate the problem further. These may include an echocardiogram, a chest X-ray, or an MRI scan. If a diagnosis is made, your doctor will ensure that appropriate specialists are present during delivery.
✓In some cases, symptoms of congenital heart defects may not appear until sometime after birth. Defects are usually found during routine physical examinations. Newborns with heart defects may experience:
✓bluish lips, skin, fingers, and toes
✓shortness of breath or difficulty breathing
✓feeding difficulties
✓low birth weight
✓chest pain
✓delayed growth
✓How is Congenital Heart Disease Diagnosed?
Tests to diagnose heart defects may include:
✓Physical examination, which involves listening to the heart with a stethoscope.
✓Chest X-ray
✓Electrocardiogram to test heart rate patterns
✓Echocardiogram (uses sound waves to take pictures of the heart).
✓Cardiac catheterization (a thin tube is inserted into the heart through a blood vessel to obtain details about heart function).
✓Before Birth
Doctors may find certain problems during pregnancy. Your doctor may detect a defect before your baby is born with the following:
✓Fetal echocardiogram. This test uses ultrasound images to show the heart in motion, allowing your doctor to see abnormalities in the heart valves and structure.
✓Genetic testing. A geneticist takes a small blood sample before or during your pregnancy. This is important because if you or a family member has an abnormality, your child's chances of having it can increase up to 50%.
✓In Childhood
Other problems may also be found in babies or children. The doctor listens to your child's heartbeat to check their health. If they hear an unusual sound or heart murmur, they may request further tests such as:
✓Echocardiogram: This is a painless type of ultrasound that takes pictures of the heart. It can detect almost any type of congenital heart defect and usually takes less than an hour.
✓Electrocardiogram (EKG): This measures the electrical activity of the heart. This test can diagnose heart rhythm problems called arrhythmias and can find parts of the heart that are too large or working too hard.
✓Chest X-ray: An X-ray can show your doctor signs of an enlarged or unusually shaped heart and can reveal signs of heart failure, such as fluid in the lungs.
✓MRI and CT scans: Magnetic resonance imaging and computed tomography scans are two other types of imaging tests that can provide detailed images of the heart.
✓Pulse oximetry: This measures oxygen levels in your child's blood through a finger sensor. If it shows too little, it may indicate a heart problem.
✓Cardiac catheterization: If any of the previous tests show that your child has congenital heart defect, your doctors may recommend cardiac catheterization. A doctor guides a very thin, flexible tube (called a catheter) from a blood vessel in the arm or leg to reach the heart. They insert dye through the catheter and then use X-ray videos to see inside the heart.
✓How is Congenital Heart Disease Treated?
Medications: There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.
✓Implantable Heart Devices: Some complications associated with congenital heart defects can be prevented by using certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD can correct life-threatening irregular heartbeats.
✓Catheter Procedures: Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will place a thin tube in a blood vessel in the leg and guide it to the heart. Once the catheter is in the correct position, the doctor will use small instruments passed through the catheter to correct the defect.
✓To treat pulmonary valve narrowing, the catheter is equipped with a small balloon that is inflated in the pulmonary valve to separate the fused leaflets.
✓Open Heart Surgery: If catheter procedures are not sufficient to repair the congenital heart defect, this type of surgery may be necessary. A surgeon can perform open heart surgery to close holes in the heart, repair heart valve leaflets, or widen blood vessels.
✓Heart Transplant: In rare cases where the congenital heart defect is too complex to be corrected, a heart transplant may be necessary. During this procedure, the child's heart is replaced with a healthy heart from a donor.